Home Health A-Z Blue Baby Syndrome : Symptoms, Causes and Treatments

Blue Baby Syndrome : Symptoms, Causes and Treatments

Verified By Apollo Doctors September 28, 2022 3119 0
Infant Methemoglobinemia (Blue Baby Syndrome)
Infant Methemoglobinemia


Blue baby syndrome is a condition some babies are born with or develop early in life. It’s characterized by an overall skin colour with a blue or purple tinge, called cyanosis. The baby can be born with it or develop the condition during an early period of its life.

This blog comprehensively describes the blue baby syndrome, its symptoms, causes, and treatments.

What is a blue baby syndrome?

Blue baby syndrome is a condition characterized by a change in skin colour in babies. The bluish tint is most evident in thin skin areas such as the lips, earlobes, and nail beds. It is due to heart, lung, or blood abnormalities. The baby takes on a bluish hue because of poorly oxygenated blood. Normally, blood is pumped from the heart to the lungs, where it receives oxygen. The blood is circulated back through the heart and then throughout the body.

When there’s a problem with the heart, lungs, or blood, blood may not be oxygenated properly. This causes the skin to take on a blue colour. The lack of oxygenation can occur for several reasons.

What are the symptoms of blue baby syndrome?

The following are some of the symptoms of the blue baby syndrome.

  • Skin turns blue
  • Irritability
  • Rapid breath or heartbeat
  • Baby refuses to feed
  • Low weight gain
  • Lethargy

When to see a doctor?

Contact the healthcare provider immediately if one observes a bluish hue on the baby with shortness of breath and rapid heartbeat.

What causes blue baby syndrome?

The blue baby syndrome may occur due to congenital or environmental issues. It is primarily due to underlying heart disease, such as the following:

Tetralogy of Fallot (TOF)

While a rare congenital heart defect, TOF is a primary cause of blue baby syndrome. It’s actually a combination of four heart defects that can reduce blood flow to the lungs and allow oxygen-poor blood to flow out into the body.

TOF includes conditions like having a hole in the wall that separates the left and right ventricles of the heart and a muscle obstructing the flow of blood from the right ventricle into the pulmonary, or lung, artery.

  • Truncus arteriosus: Some babies are born with one artery (instead of two) to carry blood from the heart to different organs in the body. In this defect, one pulmonary valve may also be missing. It may reduce the supply of oxygenated blood.
  • Tricuspid and pulmonary atresia: These conditions are characterized by the improper working of tricuspid and pulmonary valves, respectively. Both these are valves to let the blood flow in one direction through the heart. The improper functioning of these valves will restrict the natural flow of oxygenated blood to the body.
  • Atrioventricular canal defect: The heart is divided into two parts to avoid mixing oxygenated and de-oxygenated blood. However, some babies may be born with heart issues that let the oxygenated and de-oxygenated blood be combined, causing severe health issues, one of them being a bluish hue all over the body.
  • Pulmonary hypertension: The baby may face abnormally high blood pressure when the number of arteries in the lungs is less or too narrow. It may restrict the blood flow resulting in blue baby syndrome.


This condition stems from nitrate poisoning. It is can happen in babies who are fed infant formula mixed with well water or homemade baby food made with nitrate-rich foods, like spinach or beets.

The condition occurs most often in babies under 6 months of age. When this young, babies have more sensitive and underdeveloped gastrointestinal tracts, which are more likely to convert nitrate into nitrite. As nitrite circulates in the body, it produces methemoglobin. While methemoglobin is oxygen-rich, it doesn’t release that oxygen into the bloodstream. This gives babies with the condition their bluish hue.

Methemoglobinemia can also rarely be congenital.

Other congenital heart defects

  • Genetics cause most congenital heart defects. For example, babies born with Down syndrome often have heart problems.
  • Issues with maternal health, such as underlying and poorly controlled type 2 diabetes, can also result in a baby developing heart defects.
  • Only a few congenital heart defects cause cyanosis.

What are the complications of blue baby syndrome?

Blue baby syndrome if left untreated, the limited supply of oxygen to different organs results in improper functioning, affecting the baby’s overall well-being and can even be fatal.

How can blue baby syndrome be diagnosed and treated? 

The healthcare provider would conduct physical exams and tests to confirm this condition. Besides blood tests, the doctor may also recommend ECG, EKG, chest X-ray, cardiac catheterization, and oxygen saturation test to diagnose the condition. 

The treatments depend on the causes. If the condition is due to heart issues, it must be corrected first, and if it is due to nitrate poising, prescribed medications can reverse the condition.

What are the preventive measures for blue baby syndrome?

Congenital blue baby syndrome is not preventable. However, for external factors, there are few preventive measures, such as:

  • Avoid using water from the well to prepare formula food for babies 
  • Avoid nitrate-rich food such as spinach, broccoli, beetroot, and carrot 
  • Say no to illegal drugs, cigarettes, and alcohol during pregnancy
  • Control maternal diabetes during pregnancy


Even though blue baby syndrome does not have a particular treatment or preventive method, the causes can be treated effectively with advanced technology. It has reduced the mortality rate. The condition is preventable with apt measures. 

Frequently Asked Questions

Is the oxygen saturation measurement test painful?

No. The test is not painful. It involves attaching a lighted probe to the baby’s finger or toe to collect the blood oxygen measurements.

Is cyanosis another name for blue baby syndrome?

Yes. Cyanosis is the discolouration of the skin due to a lack of oxygenated blood in the body, but it also affects adults. It can happen due to the narrowing of blood vessels due to low temperatures. It can also be due to some underlying problems. 

Verified By Apollo Doctors
At Apollo, we believe that easily accessible, reliable health information can make managing health conditions an empowering experience. AskApollo Online Health Library team consists of medical experts who create curated peer-reviewed medical content that is regularly updated and is easy-to-understand.

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